FDA Adverse Event Malfunction Summary report: N

7.5CM ANGLE ATTACHMENT

MDR report key: 3811245 · Received October 11, 2013

Report

Report Number
1045834-2013-13830
Event Type
Malfunction
Date Received
October 11, 2013
Date of Event
February 23, 2012
Report Date
February 23, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
K011444
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS REC'D BY DEPUY SYNTHES POWER TOOLS. THE INVESTIGATION IS STILL IN PROCESS. WHEN THE INVESTIGATION HAS BEEN COMPLETED OR ADD'L INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT REC'D FROM THE USA STATING THAT THE DEVICE WAS HEATING UP. THE DEVICE WAS NOT BEING USED DURING SURGERY. THERE WERE NO INJURIES BUT IT IS UNK IF MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
523996 7.5CM ANGLE ATTACHMENT MOTOR, DRILL, ELECTRIC/ATTACHMENT, PRODUCT CODE: HBC HBC DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1